Q: Why do some children with schizophrenia become depressed?
JR: I think this is a very taxing, a very stressful condition for the child to have. The children are aware that they've lost many of their abilities. Some of the children, a fraction of ours for example, were students. It's not just that the voices interfere, but there's something about the process that does make it harder for them to think and concentrate.
The children are very sad. They see that they don't have friends, and that they're different and not all of them, but many of them, are actually very aware of what they are losing by having this disorder.
Q: What's the long-term prognosis for children with this mental illness?
JR: It's a chronic disease, and the prognosis depends on several things, but very few really ever reach a point that no one knows they have schizophrenia. We do have maybe a fifth of our sample who, on medication, function almost completely normally. But some degree of impairment remains, and the degree of support that they have from their school, their family, their community, makes a huge difference on what the rest of their life is going to be like.
Q: What warning signs can parents look for in children?
JR: If a child comes up with ideas and beliefs and behaviors that are significantly interfering with his or her life, I think you do want to get psychiatric or psychological consultation. If whatever they tell you doesn't help a few months later, you probably need to get another one.
These [children] tend to be violent, and they tend to be very bizarre. For example, a child who insists that their parents are not their real parents ... that's not a healthy thing. And [if they're] very concerned and very suspicious of their parents, that's more likely to be a paranoid problem.